A living will is an important tool used in estate planning. It provides instructions for what kinds of medical care you want to receive or decline in the event a serious illness or injury has left you unable to make decisions in the moment.
Living wills could spare your family the pain of making difficult decisions without knowing your wishes. They help ensure you don't end up getting medical treatment you'd prefer not to receive. They could also ensure that measures are used to prolong your life if that's what you'd prefer.
You could work with an estate planning attorney to create a living will, but you don’t necessarily have to. In fact, with some simple information on how to write a living will, you could do this process yourself. This guide will help you figure out how to create a living will that provides guidance on crucial medical decisions.
What is a living will?
A living will is a legal document used to provide instructions in advance on medical care in case you become too sick or hurt to express your wishes.
Living wills are a type of advance health care directive you use to take control over your future health care decisions. The purpose of a living will is to make your position clear on specific types of medical care that might be needed in an emergency situation. For example, you may specify whether you would prefer to have CPR used to resuscitate you or whether you'd accept or decline the use of a feeding tube or ventilator to prolong your life.
Many people make a living will because they want maximum control over what extraordinary measures are used to treat them.
Living wills are not the same as a last will and testament. A last will and testament is used to specify who should inherit your assets after you die. A living will, on the other hand, includes instructions that could be needed about your care if you are alive but cannot express your medical preferences at the time decisions must be made.
What is a power of attorney for health care?
Living wills are often created in conjunction with a durable health care power of attorney, though these two estate planning documents serve different purposes.
Although a living will specifies your wishes on specific medical interventions, a medical power of attorney allows you to name a person who will make decisions about your medical care if you cannot. When you create a durable power of attorney, you appoint someone you trust as your health care proxy. This person will act in your best interest and make decisions on your behalf when you cannot make choices on your own about your care.
Durable powers of attorney for health care and living wills work together to offer a comprehensive solution for controlling your future medical care. If the living will specifies your position on a particular kind of care, it will control what happens to you. If a decision needs to be made that the living will doesn't address, then the person who has been given power of attorney will make that choice.
You could also choose to make one document but not the other. For example, if you're uncomfortable specifying in advance whether you would want CPR or a ventilator used to prolong your life, you could simply opt to name a health care agent using power of attorney in lieu of a living will.
What to consider for a living will
When you create a living will, you need to consider several key issues, including the following:
- What types of decisions might need to be made in an emergency situation: This will usually include choices about whether to use artificial or mechanical treatments to keep you alive in an emergency. Examples could include the use of CPR, a ventilator, tube feeding, artificial hydration through an IV, or comfort care such as pain management treatment, also known as palliative care, and hospice services.
- How comfortable you are with various medical interventions: Once you know the kinds of decisions that will have to be made, you'll have to think about your position on each one. For example, you may decide you aren't comfortable with a feeding tube but that hand feeding is OK — especially in cases of patients with dementia.
- How you prioritize different quality of life issues: For example, you'll need to think about the circumstances under which you would prefer to be kept alive versus when you would prefer not to have your life extended through artificial means. You may, for example, want resuscitation with CPR after a stroke if there is a chance of recovery, but not if you are likely to have sustained substantial damage to the brain and would be unable to care for yourself or live independently.
- What other specific interventions you have an opinion on: You may want to provide instructions related to specific medical treatments you may need due to a condition you have. For example, you may want to explain your preferences on kidney dialysis or blood transfusions if your doctor has indicated they may become necessary due to the nature of your medical issues.
- What decisions you're comfortable having your health care proxy make: If you have created a durable power of attorney for health care, or plan to do so, then you'll be appointing someone to make decisions on your behalf that are not addressed in your living will. Consider what types of decisions you'd prefer to leave up to your chosen proxy rather than make in advance and include in the living will.
By thinking about these issues, you can make the best and most informed choices about the types of medical guidance you want to use your living will to provide.
How to write a living will
Just as you could write a will without a lawyer, you could also create a living will on your own. Estate planning lawyers specialize in preparing these types of document, but if you want to write one yourself, these are the steps you'll need to take.
Talk with your doctor about the types of medical decisions that may arise
You'll want to be fully informed about the medical issues likely to come up, and prepared to make decisions about what kinds of care you are willing to receive or would prefer to decline. Your doctor could help you to understand and consider these issues.
Obtain the necessary legal forms
Most states have standardized living will forms that you could use. Local Area Agencies on Aging generally have these forms available for free. Health care providers may also be able to provide the forms for you.
Complete the paperwork
You'll want to complete the form with as much detail as possible. This could include addressing issues such as what kinds of care you want as well as whether you would like to make organ donations after your death.
Have your documents witnessed or notarized if necessary
In some states, your signature on your living will need notarization. Banks, post offices, and insurance agents usually have a notary public. In other cases, you may need witnesses to attest to the fact that you created and signed your living will yourself.
Store your living will in your state's registry
If your state has a registry of living wills or advance health care directives, be sure to store your forms with the registry. This allows medical professionals to access information on your health care wishes. Once you have stored your living will, be sure to update it if you make any changes either due to changes in state laws or a personal change in position on medical issues.
Consider making living wills for any state where you spend significant time
If you spend time in multiple states often, be sure you have a separate living will for each one. This could be an issue, for example, if you have extended visits with children or grandchildren in a different location or if you are a snowbird who spends summers and winters in different places.
What should you do with your living will?
After you have created your living will and other advanced directives, you’ll want to keep copies of your documents in a safe place (possibly as part of a death binder). It's also very important that the documents be distributed properly so the right people know about them and can follow your wishes. There are a few key things you should do to make sure that the instructions in your living will are followed:
- Check if your state has a registry of advanced directives. If so, you can store a copy of your living will and health care power of attorney with this registry so that health care providers can easily access the documents.
- Provide a copy to your health care proxy (and any alternate proxies). This is the person, or people, whom you have appointed to make decisions on your behalf when creating your durable power of attorney.
- Give a copy to health care providers . This should include your primary care doctor so a copy can be kept with your medical records. If you are going into the hospital or receiving care with a new provider, you may want to ensure they have a copy as well.
- Provide a copy to loved ones. Family members who will likely be notified in case of a medical emergency should have a copy of your living will so they know your wishes.
What’s the difference between a living will and a will?
A last will and testament is used to provide instructions on the disposition of your property. You could specify who inherits assets. You could also use a will to name a guardian for your children. A living wil, is used to provide instructions on medical care you wish to receive or decline in case of an emergency. A living will addresses issues such as whether you should undergo CPR or whether a ventilator or feeding tube should be used to keep you alive.
What are the benefits of having a living will?
A living will allows you to control your future medical care in case you become incapacitated. You can make decisions about what kinds of medical interventions you would want if you become seriously ill, badly injured, or have a terminal condition. This way, you aren't forced to undergo treatments you wouldn't want, aren't put on life support under circumstances where you would prefer not to be, or aren't refused medical interventions you might prefer to receive.
Having a living will also enables you to spare your loved ones from tough choices. It could be hard for your family to decide whether to withhold a feeding tube or other life-saving care if they don't know your wishes on acceptable medical interventions or quality of life issues.
Who should you tell about your living will?
You should provide a copy of your living will to your health care providers, and you should see whether your state has a registry for living wills. You should also tell close family who are likely to be contacted if you become seriously injured or hurt, and you should give a copy to anyone you name as a health care proxy when creating a durable health care power of attorney. The key is to make sure that if an emergency arises, those making decisions about your care know about your living will.
Making an estate plan is a crucial part of figuring out how to manage your money, and knowing how to write your own living will is a key part of the estate planning process if you don't plan to work with a professional.
If you aren't comfortable doing this process on your own, getting legal advice from a lawyer could be a good idea, as these are important matters to address to ensure that your wishes are respected if the worst occurs. Although it can be difficult to consider potential end-of-life issues, having a living will in place could provide you with peace of mind.
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